EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY;

Objective: To determine the efficacy of Alpha blocker as adjunctive medical therapy , which increases the stone clearance afterextracorporeal shock wave lithotripsy (ESWL) to treat renal stones. Design: Quasi Experimental study. Setting: Department of Urology,Liaquat National Hospital, Karachi. Period: September 2010 to March 2011. Materials & Method: Ultrasound guided Dornier Alpha Impactlithotripter was used for shock wave lithotripsy. Study was carried out on 60 patients who underwent single session of ESWL for renal calculus.Patients were divided in two groups, Group A (n=30) received conventional treatment and Group B (n=30) received Alpha-1 Blocker in additionto conventional treatment. All patients were evaluated with X-ray and Ultrasound (KUB) after 2 weeks and repeated at the end of month. Failureis defined as unsuccessful expulsion after 4 weeks and patient desire to remove the stone before day 30. Result: Out of 60 patients, 45(75%)were males and 15(257%) were females with male to female ratio was 3:1. The average age of the patients was found 36.32 ± 14.8 (Rangingfrom 15 to 75) years. Complete clearance was achieved in 76.7% of those receiving Alpha-1 Blocker and in 46.7% of controls at 1 month (P =0.001). This difference was statistically significant. Conclusions: The results of my study demonstrate that Alpha-1 Blocker therapy, as anadjunctive medical therapy after ESWL is more effective than lithotripsy alone for the treatment of patients with large renal stones and is equallysafe.

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A Prospective Longitudinal Study onthe Predictability of Quadruple-D Score in the Success Rate of Extracorporeal Shock Wave Lithotripsy for Renal Stones 1-2cm in Diameter

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48698.14919 ◽

2021 ◽

Author(s):

Soumish Sengupta ◽

Supriya Basu ◽

Kadambari Ghosh

Keyword(s):

Computed Tomography ◽

Shock Wave ◽

Scoring System ◽

Shock Wave Lithotripsy ◽

Renal Stones ◽

Extracorporeal Shock Wave ◽

Group A ◽

Group B ◽

Stone Density ◽

Free Status

Introduction: Quadruple-D, based on Computed Tomography (CT) derived metrics, is a scoring system that helps urologists to predict the Stone Free Rate (SFR) following Extracorporeal Shock Wave Lithotripsy (ESWL) in renal stones. Aim: To evaluate the efficacy of Quadruple-D scoring system to assess the SFR in individuals with renal stones measuring 1-2 cm in diameter after giving ESWL. Materials and Methods: The study was conducted on 120 patients. Systemic random sampling technique was applied with a sampling interval of two. Quadruple-D scoring, comprising of four Computed Tomography (CT) based metrics that is stonedimension, stone density, Hounsfield units (HU), Skin-to-Stone Distance (SSD) and stone location, was done prior to ESWL. The scores ranged from zero (worst) to four (best) points. Plain abdominal radiography was done three weeks after ESWL to assess SFR. Complete clearance was considered the stone free status. Patients were divided into group A with complete stone clearance and group B with residual stone. All the statistical analysis was done using IBM SPSS 26.0. Student’s t-test or Mann-Whitney U-test was used to compare continuous variables. Fisher’s-exact test and Chi-square test were used to analyse the cross charts between two categories. Results:The mean ellipsoid Stone Volume (SV) was 396.44±163.23 mm3 and 395.81±227.52 mm3 in group A and B, respectively. The stone density was 724.28±210.90 in group A and 814.56±190.63 in group B. In group A, 9.20% and in group B, 34.09% of the patients had stones in lower calyx. The difference between the groups based on the above parameters were statistically significant. The Quadruple-D score was 2.09±0.65 and 1.54±0.79 in group A and B, respectively. The Area Under the Curve (AUC) of Quadruple-D scoring system was 0.674. The age, sex, BMI, laterality of the stone and SSD did not predict stone-free status in this study. Conclusion: Quadruple-D scoring system has been successfully validated as the SFR showed a parallel increase with every positive component. Quadruple-D is an easy to use clinical tool to predict the success rate of ESWL.

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COMPARISON OF THE SUCCESS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) WITH AND WITHOUT DJ STENTING IN PROXIMAL URETERIC STONE

Journal of University Medical & Dental College ◽

10.37723/jumdc.v11i2.303 ◽

2020 ◽

Vol 11 (2) ◽

pp. 21-24

Author(s):

Dr. Mudassar Saeed Pansota

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

P Value ◽

Ureteric Stone ◽

Extracorporeal Shock Wave ◽

Dj Stent ◽

Group A ◽

Group B ◽

Average Size

BACKGROUND & OBJECTIVE: There is disagreement in the use of ureteral double-J stent before the extracorporeal shock wave lithotripsy (ESWL), although most of the urologists suggest using stent in shock wave lithotripsy technique for stones bigger than 20mm, for preventing the risk of developing steinstrasse. To compare the success of ESWL with and without DJ stenting in proximal ureteric stone. METHODOLOGY: A total of 60 patients form both genders, between 15 to 55 years of age, with a single proximal ureteric stone, were included. Patients with solitary functioning kidney, multiple stones, pregnancy, pyonephrosis and sepsis were excluded. In Group-A, ESWL without DJ stenting was completed while in Group-B, ESWL with DJ stent placement was done. In all patients, at least 4 sessions were done fortnightly. Patients were followed regularly and ﬁnal success was noted after one month of completion of ESWL sessions. RESULTS: The mean age was 36.85 ± 8.61 years. From 60 patients, 29 (48.33%) were men and 231 (51.67%) were women.Mean body mass index (BMI) was 28.30±2.20 kg/m . The average size of the stone was 12.47 ± 2.57 mm. Success (according to stone removal) of Group-A (ESWL without DJS) was seen in 26 (86.67%) patients while in Group-B (ESWL with DJS) was seen in 16 (53.33%) patients with P-value of 0.005. CONCLUSION: This study concluded that success (in terms of stone clearance) of extracorporeal shock wave lithotripsy (ESWL) without DJ stenting is higher compared to with DJ stenting in upper ureteric stone.

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Comparison of Slow Rate versus Fast Rate Extracorporeal Shock Wave Lithotripsy in Patients with Urolithiasis

10.53350/pjmhs211561921 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1921-1923

Author(s):

Muhammad Musa Kakar ◽

Asadullah . ◽

Masha Khan ◽

Ijaz Ur Rehman

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Lithotripsy ◽

Slow Rate ◽

Shock Wave Lithotripsy ◽

Fast Rate ◽

Female Patients ◽

Extracorporeal Shock Wave ◽

Group A ◽

Male Patients ◽

Group B

Objectives: To compare the success of slow rate with fast rate extracorporeal shock wave lithotripsy in patients undergoing treatment of urolithiasis. Study design: Randomized controlled trial Place & Duration of Study: This study was conducted in Urology Department of Sandeman Civil Hospital, Quetta for one year duration from 1stApril 2020 to 30thMarch 2021. Methods: Total ninety patients who were divided in two equal groups i.e. Group A in which patients received treatment with slow rate extracorporeal shock wave lithotripsy and group B in which patients received treatment with fast rate extracorporeal shock wave lithotripsy. Results: There were 32 (71.1%) male patients and 13 (28.9%) female patients in group A. In group B, there were 28 (62.2%) male patients and 17 (37.8%) female patients. Mean age in group A was 35.61+4.19 years while in group B, the mean age was 34.11+69.32 years. The success rate of slow rate extracorporeal shock wave lithotripsy was 36 (80%) and that of fast rate extracorporeal shock wave lithotripsy was 21 (46.7%) (p-<0.05). Conclusions: The slow rate extracorporeal shock wave lithotripsy is better than fast rate extracorporeal shock wave lithotripsy for elimination of urolithiasis. Keywords: Extracorporeal shock wave lithotripsy, Slow rate ESWL, Fast rate ESWL

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Comparing 60 versus 120 shocks per minute for shock-wave lithotripsy of solitary renal calculi: A controlled randomized study

Journal of Clinical Urology ◽

10.1177/2051415820945924 ◽

2020 ◽

pp. 205141582094592

Author(s):

Tamer A Ali ◽

Mohamed A Abdelaal ◽

Moamen M Amin ◽

Mohamed K Saif-Elnasr

Keyword(s):

Shock Wave ◽

Shock Wave Lithotripsy ◽

Randomized Study ◽

Renal Stones ◽

Renal Calculi ◽

Successful Outcome ◽

Significant Difference ◽

Group A ◽

The Difference ◽

Group B

Objective: This study aimed to compare the difference in outcome of shock-wave lithotripsy (SWL) using a slow rate of 60 shocks per minute versus a rapid rate of 120 shocks per minute generated by an electromagnetic lithotripter for renal calculi. Methods: From May 2017 to June 2019, 156 patients ( Mage=38.7 years) with single radio-opaque renal stones smaller than 20 mm were included and randomly divided into two groups: group A, 78 patients who received 60 shocks per minute; and group B, 78 patients who received 120 shocks per minute. Patients were radiologically reviewed at 3 months for an outcome. Results: There was no statistically significant difference between mean stone area treated ( p=0.222) or additional analgesic use in the form of patient-controlled analgesia (PCA; alfentanil; p=0.82). A successful outcome was defined by fragments smaller than 4 mm or stone-free status. In group A, 60% of patients had a successful outcome compared with 61.4% in group B ( p=0.869) following a single treatment. Post-treatment complications were similar in both groups at 12% for group A and 10.7% for group B ( p=0.797). Conclusions: There was no statistically significant difference between the delivery of 60 and 120 shocks per minute during SWL for the treatment of solitary renal stones with a mean stone area of 62 mm2 regarding the outcome, complications or PCA use when using a Dornier Compact Delta II lithotripter.

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Single Centre Experience of Slow Versus Fast Rate ESWL in Urolithiasis

10.53350/pjmhs211551068 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1068-1070

Author(s):

Jmail Rahim ◽

Jamshed Rahim ◽

Ghazi Khan ◽

Saad Ali Khan ◽

Athar Mahmood ◽

...

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Lithotripsy ◽

Slow Rate ◽

Shock Wave Lithotripsy ◽

Fast Rate ◽

Controlled Trial ◽

Extracorporeal Shock Wave ◽

Single Centre Experience ◽

Group A ◽

Group B

Aim: To compare the success of slow rate with fast rate extracorporeal shock wave lithotripsy in the treatment of urolithiasis. Study design: Randomized controlled trial Place & duration of study: Department of Urology, Shaikh Zayed Hospital, Lahore from 1st October 2010 to 30th April 2011. Methodology: One hundredpatients who were divided in two equal groups i.e. Group A in which patients received treatment with slow rate extracorporeal shock wave lithotripsy and group B in which patients received treatment with fast rate extracorporeal shock wave lithotripsy. Results: The success rate of slow rate extracorporeal shock wave lithotripsy was 76 % and that of fast rate extracorporeal shock wave lithotripsy was 48% (p-<0.05). Conclusions: The slow rate extracorporeal shock wave lithotripsy is better than fast rate extracorporeal shock wave lithotripsy for elimination of urolithiasis. Keywords: Extracorporeal shock wave lithotripsy; slow rate ESWL; fast rate ESWL

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EFFICACY OF SELECTIVE ALPHA-1 RECEPTOR BLOCKERS (TAMSULOSIN) IN FACILITATING THE PASSAGE OF RENAL STONES AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

Journal of University Medical & Dental College ◽

10.37723/jumdc.v12i1.429 ◽

2021 ◽

Vol 12 (1) ◽

pp. 36-43

Author(s):

Dr. Nauman Khalid ◽

Aijaz Hussain Memon ◽

Wasim Sarwar Bhatti ◽

Hanan Noor ◽

Muhammad Waqas Iqbal ◽

...

Keyword(s):

Shock Wave ◽

Clearance Rate ◽

Shock Wave Lithotripsy ◽

Diclofenac Sodium ◽

Renal Stones ◽

Stone Clearance ◽

X Ray ◽

Group A ◽

Group B

BACKGROUND & OBJECTIVE: Urinary system stone disease is a common entity. Small renal stones are preferably treated using Extracarporeal Shock Wave Lithotripsy (ESWL) technique. Passage of stone fragments result in pain, hematuria and urinary tract obstruction. This can be avoided by the use selective α-1 receptor antagonists like Tamsulosin. However, their efficacy remains a matter of debate. In this study the role of selective α-1 blocker was evaluated in facilitating spontaneous expulsion of renal stone fragments after ESWL. The objective of our study was to find out the Efficacy of Tamsulosin (Selective α-1 blocker) in facilitating the transit of stone fragments (4-7mm) after ESWL. Follow up X-ray KUB was used to confirm the stone clearance. Efficacy was measured in terms of stone expulsion rate. METHODOLOGY: It was randomized controlled trial including 150 patients coming to outpatient department of Urology Lahore General Hospital, Lahore from January 25, 2010 to July 25, 2010. Total 150 patients with renal stones broken down into fragments (4-7mm) after ESWL were enrolled using non-probability purposive sampling technique. Patients were categorized into group A and B. Patients of group A received cap. Tamsulosin 0.4mg along with Tab. Diclofenac sodium 50mg. Whereas, patients belonging to group B received only diclofenac sodium 50 mg twice daily. Patients underwent ESWL every three weeks, in case of non-fragmentation, to the maximum of 4 sessions. All the patients were followed with X Ray KUB for stone clearance. The data of all patients was incorporated into pre designed Performa. Statistical evaluation of clinical variables done in terms of efficacy i.e. stone clearance. RESULTS: Stone clearance rate of patients in group A was 86.6% as compared to only 76% in group B. Usage of selective α-1 blockers in group A enhanced the stone clearance rate as compared to group B. However this difference was statistically insignificant (p-value-0.094). CONCLUSION: There was increased stone clearance in alpha one blocker group but not statistically significant. Further studies with larger sample size are required to evaluate the role of Selective α-1 blockers (Tamsulosin) after ESWL.

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